In-Person Couples Therapy

In-person couples therapy allows for fewer limitations than on screen

We often say, half joking, that couples are on their best behavior when they come to couples therapy, but that doesn’t last. Good thing. The difficult messes of a relationship need to be contended with in therapy. Part of what couples therapy challenges, at its best, is the strict privacy of love relationships and family. Many cherish the relationship as a private space, but that privacy doesn’t always serve couples well. Working with a couples therapist is an act of inviting someone into your relationship. Having a therapist see the mess and the struggle, coming to know the relationship as much as possible, offers the opportunity to guide and help. 

When this invitation comes with strict controls, like only relating to a couple through a screen, it limits how helpful a couples therapist can be. In-person couples therapy allows a therapist to see the relationship more fully in an environment outside of the partners’ everyday routine rather than in the comfort of their home or office. This creates a space that is closer to real life, where couples can “let their guard down” to give a therapist better insight into a relationship.

In-person couples therapy creates the conditions to talk about what couples are avoiding

Couples frequently would rather relate to life, including therapy, as a context in which to keep it together, put on a brave face, and show their best side. However, this isn’t always what’s better for therapy (It’s a little bit like going to the doctor for help with a rash, but insisting you keep your clothes on). Sometimes, a relationship has issues that one or both partners are afraid to raise because of the desire to avoid hurt feelings or an angry response. In other instances, some things need to be said that the individual or couple didn’t realize needed to be said. In-person couples therapy can help create the conditions to talk about the things couples have been avoiding.

To be clear, sometimes remote work can be particularly helpful in these cases, providing the safety of distance and insight into a different space, like a couple’s home, where the therapist rarely travels. At the same time, we’ve all become accustomed to the container of remote work and are aware of the restrictions of what it means to be doing online therapy from a work computer. In-person couples therapy allows a therapist to see all of the complexity of a given situation and the individuals within it—the hurt, the sadness, the difficulty with articulating and talking through—that can be more easily avoided on screen.

Couples therapy in person can offer couples the safety to be messy or fall apart

When people are frightened, particularly in a love relationship, there is a good deal of vulnerability, uncertainty, and fear. There are many ways a couples therapist can help bring the kind of safety that allows partners to be messy or fall apart. Though this can occur online, the therapist has more to work with when they’re in the room with the couple, through providing a sense of embodied safety with their tone of voice and physical presence. For instance, it’s not unheard of for a couples therapist to need to help a partner breathe through a moment of being frightened that might otherwise lead to a panic attack. A therapist can also help an individual process feelings without embodying them in ways that could be scary for their partner.

It helps to be physically in the room together when contending with what’s happening “in the room”

In remote couples therapy, couples sometimes log on from separate locations—one partner might be at home while the other is in their office. Like the therapist, they’re not really “together” either. The session, then, becomes more transactional, similar to a meeting. The session can become overcome with a type of “aboutness,” wherein the therapist and the couple talk about the relationship rather than doing the relationship in real time. Partners might discuss their week or conflicts, but at the same time, there is a kind of performance of keeping it all together.

Although this can also occur in person, the setup of talking on the phone or a laptop can keep the conversation in this mode of talking about rather than looking at what’s happening live. While both can be important in therapy, some of the better moments are when a couple and therapist engage with what’s happening “in the room.” This can happen remotely, but it helps to be in the room when talking about what’s happening “in the room.”

Trivial in-between moments matter in couples therapy

How do partners interact in the waiting room? Do they arrive together or separately? Is one partner always late? These in-between moments may seem marginal and trivial, but they matter in therapy, more so with couples. While a therapist can still observe when partners log on and from where, online therapy tends to start and end exactly at the beginning of the session. There’s no getting up and leaving the room to go to the bathroom or hang up a coat. There’s no observing how partners relate to each other physically through their entire body, not just what’s on screen. These communications that aren’t necessarily unconscious but aren’t considered in the same way are the sort of metadata of therapy, which produces important opportunities for a couples therapist.

In-person couples therapy can get to the root of what’s really going on in a relationship

As couples therapists, we always sit with the question: What’s really going on in a couple’s relationship? As we often say, “The fight about toothpaste isn’t really about toothpaste.” Knowing that is easy, but figuring out what the couple is really fighting about can present a bigger challenge. What is at the root of the conflict? Why has this couple lost connection? A couples therapist’s goal is to disrupt the narrative. In most cases, though we can do so in remote therapy as well, we can do this more successfully in person.

Why? In-person therapy is better for the same reason a live concert is better than watching on TV or listening to a recording. It’s better for the same reason why being at a live sporting event is better, or going on a date is better than chatting through video. One of the projects of couples therapy is to help couples be more fully in the world. In-person therapy allows for the greatest expression of this as possible.